COMPLICATIONS - METABOLIC

M. Malinowski¹, T. Konrad², S. Nolting¹, D. Hünerbein¹, H. Dobling¹, T. Steinmüller¹, A. Pfützner³, J.F. Lock¹, P. Neuhaus⁴, M. Stockmann^1
1Department Of General, Visceral And Transplantation Surgery, Charité, Berlin/GERMANY, ², Institute for Metabolic Research, Frankfurt/GERMANY, ³, Institute for Clinical Research and Developement, Meinz/GERMANY, ⁴Department Of General, Visceral And Transplant Surgery, Charité Campus Virchow, Berlin/GERMANY

Body: Introduction The adiponektin (APO) serum levels correlate negatively with the insulin resistance and the risk of cardiac death by the individuals with normal liver function. Proinsulin (P-INS) is a surrogate parameter of the ß-cell function and its level increase while insulin resistance takes place. The influence of the liver function on the APO and P-INS metabolism alteration remains unclear. In this study the influence of cirrhosis, and liver transplantation on the APO and P-INS metabolism was analyzed. Methods Eighteen recipients and donors who undergone living donor liver transplantation were analyzed. Routine laboratory and clinical parameters, insulin resistance (i.v. GTT), APO, and P-INS serum levels were measured at the point of evaluation, 10-th, 180-th, and 365-th day after transplantation. Results APO level at the point of evaluation was low in the donor and high in the recipient group. In the donors APO levels increased at day 10-th (p=.002) and did not changed significantly till the 365 day. In the recipient group the level improved already at the 10-th day and increased slightly till POD 365 (p=0.009). P-INS level in the recipient group was also high before transplantation and improved already at the day 10. It falls continuously till the day 180 and rise slightly till the day 365 (p<.005). P-INS level in the donor group remained constant regardless the postoperative acute insulin resistance. Conclusions Liver cirrhosis grade and liver dysfunction serum parameters correlate significantly positive with the APO serum level. In patients with liver cirrhosis contrariwise to the individuals with sufficient liver function hyperinsulinemia and insulin resistance do not cause APO down regulation. In the patients with liver cirrhosis P-INS levels can not be used for the insulin resistance monitoring due to the influence of the liver function on its clearance.

Disclosure: All authors have declared no conflicts of interest.